Coughing Caution

Pertussis (aka whooping cough) was one of the leading causes of childhood illness and death in America during the early part of the 20th century. Thanks to the widespread use of a vaccine developed in the 1940s, pertussis cases declined dramatically. But this year California declared whooping cough a statewide epidemic, and outbreaks of pertussis have increased nationwide.

"Pertussis is a highly contagious bacterial disease that can cause respiratory illness and seizures," says Anjali Rao, M.D., a pediatrician at Northwestern Memorial Hospital in Chicago. It's an airborne infection that can easily spread to infants via direct contact with anyone who has the disease or when that person breathes, coughs or sneezes nearby. Infants 6 months and younger are at the greatest risk for contracting the infection, and babies younger than 12 months are also more likely to experience complications, hospitalization and death from pertussis than any other age group. Here's what you need to know to protect your baby:

Symptoms Whooping cough starts with a runny nose, congestion, sneezing and a mild cough or fever. Within a week or two, severe coughing begins. Infants can cough violently and have difficulty catching their breath, but they generally do not make the trademark "whoop" sound that older children and adults do. "The main symptoms include cough, in paroxysms, in the absence of fever," says Blaise Congeni, M.D., director of pediatric infectious diseases at Akron Children's Hospital in Ohio.

Treatment If started early, antibiotics can treat the infection. When diagnosed later, however, these drugs won't work. Infants with severe symptoms will be hospitalized and possibly put inside an oxygen tent. Cough suppressants won't help and should not be given to infants.

Prevention One word: vaccination! Pertussis is only available in a combined inoculation with tetanus and diphtheria called DTaP. The schedule for infants is a series of four doses given at 2, 4, 6, and 15 to 18 months of age. (After the first three doses, most infants are protected against pertussis.)

The current outbreak of whooping cough is due to waning immunity, so all adults up to 65 years old should receive a dose of DTaP (immunity lasts about 10 years); this includes women who have just given birth. The Centers for Disease Control and Prevention recommends that DTaP be given immediately postpartum before being discharged from the hospital, even if you are breastfeeding. Additionally, fathers, siblings, grandparents and caregivers should be up to date with their DTaP booster if they will have close contact with an infant, Rao says.